Abstract A number of recent studies suggest that income and social inequality (as opposed to poverty itself) have detrimental consequences on people's health. These studies argue that while the poor may suffer the most from inequality, the rich also suffer. On closer inspection, however, it emerges that the basic arguments and evidence that inequality has a causal effect on health are wanting in many respects.

The history of the dyestuffs industry during the period 1775–1860 is interesting for three reasons. In the first place it was in connection with the manufacture of synthetic dyestuffs, begun in 1856, that the industrial research laboratory and the organization scientist first unmistakably appeared in the last decades of the nineteenth century. Secondly, there are the enigmas of W. H. Perkin, the man who discovered and manufactured the first coal-tar colours, but who retired somewhat abruptly from the industry in 1874: (...) just after the synthesis of alizarine. Thirdly, the dyestuffs industry was in intimate association with the textile industries which had for a long time been subject to frequent radical scientific and technological innovation. Among the most important of these we may mention John Smeaton's classic paper of 1759 on the maximum work obtainable from a given fall of water: a problem important not only for the abstract science of mechanics, but also for the design of waterwheels—the main source of power for the early textile mills. (The waterwheel was not, during the eighteenth century, the epitome of the quaint and picturesque: it was in the van of scientific and technical progress.) Again, the textile industries were quick to employ the Watt rotative engine; previously a two cylinder Newcomen engine had been tried out. Bleaching powders, based on Scheele's discovery of chlorine and its properties, were rapidly adopted: in this context one cannot help contrasting the indifference of medical science to Davy's early suggestion of using nitrous oxide as an anaesthetic; or Faraday's comment in 1818 on the anaesthetic power of sulphuric ether. The textile industries saw, over this period, a rapid succession of new machines, the pace of invention being so hot that in 1832 Charles Babbage reported that machines became obsolete long before they wore out. A Salford cotton mill was the first industrial establishment to use gas lighting: James Thomson, calico printer, introduced gas lighting to the town of Clitheroe when he installed it in his works. And there were many other important technical and scientific innovations. It was to supply these industries, so well accustomed to change, that the synthetic coal-tar dyestuffs were introduced from 1856 onwards. It is interesting that, so far as we can see, the appearance of these synthetic dyestuffs was the last in the series of major innovations in the textiles and related industries: at least until recent times. (shrink)

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

While much has been written on the cultural and intellectual antecedents that gave rise to Carolus Linnaeus?s herbarium and his Systema Naturae, the tools that he used to transform his raw observations into nomenclatural terms and categories have been neglected. Focusing on the Philosophia Botanica, the popular classification handbook that he published in 1751, it can be shown that Linnaeus cleverly ordered and reordered the work by employing commonplacing techniques that had been part of print culture since the Renaissance. Indeed, (...) the functional adaptability of commonplace heads allowed him to split and combine the book?s chapters and tables and played a notable conceptual role in the way in which he spatialized words and, to a certain extent, specimens. (shrink)

The British National Institute for Health and Clinical Excellence has recently released new guidelines for the diagnosis, treatment and prevention of the psychiatric category antisocial personality disorder. Evident in these recommendations is a broader ambiguity regarding the ontology of ASPD. Although, perhaps, a mundane feature of much of medicine, in this case, ontological uncertainty has significant ethical implications as a product of the profound consequences for an individual categorised with this disorder. This paper argues that in refraining from emphasising uncertainty, (...) NICE risks reifying a controversial category. This is particularly problematical given that the guidelines recommend the identification of individuals “at risk” of raising antisocial children. Although this paper does not argue that NICE is “wrong” in any of its recommendations, more emphasis should have been placed on discussions of the ethical implications of diagnosis and treatment, especially given the multiple uncertainties associated with ASPD. It is proposed that these important issues be examined in more detail in revisions of existing NICE recommendations, and be included in upcoming guidance. This paper thus raises key questions regarding the place and role of ethics within the current and future remit of NICE. (shrink)

The following questions arising in connection with the géométrisation of modern physics are discussed: is the physical theory a bicomponent one or everything can be reduced to space? Whether the hypothesis of the macroscopic nature of space and time deals with the theoretical or empirical structure of physical theory? Is there géométrisation of quanta or quantisation of geometry?

Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.Results: The data yielded a unique and detailed account of (...) the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated. (shrink)

The editorial in the September 1982 issue of this journal and many articles before and since have addressed the problem of informed consent. Is it possible? Is it a useful concept? Is there anything new to be said about it? In this article the basic rationale of the rule (patient autonomy) is explained and the extent of the rule explored. Various exceptions have been offered by the law and an attempt is made to catalogue the chief of these. A number (...) of specially vulnerable groups are then identified, the most important, and vexed, being children. How can informed consent be secured in the case of young patients? Finally, a few problems are mentioned in an attempt to get this subject back to reality. The appeal to the principle primum non nocere may be medical paternalism in disguise. Informed consent is the competing principle that reminds us of the primacy of human autonomy. A pointer is given to the future: even the use of sound recordings to explain medical procedures and to activate informed consent so that it may become a reality and not just a lawyer's myth, should be considered. (shrink)

In the 18th century, the concept of ‘affinity’, ‘principle’ and ‘element’ dominated chemical discourse, both inside and outside the laboratory. Although much work has been done on these terms and the methodological commitments which guided their usage, most studies over the past two centuries have concentrated on their application as relevant to Lavoisier's oxygen theory and the new nomenclature. Kim's affinity challenges this historiographical trajectory by looking at several French chemists in the light of their private thoughts, public disputations and (...) communal networks. In doing so, she tells a complex story which points to the methodological and practical importance of industrial and medical chemistry. The following review highlights the advantages and snares of such an approach and makes a few historiographical points along the way. (shrink)

This essay addresses mineral water as a medical, experimental and economic material. It focuses on the career of the Reverend Dr William Laing , a physician and cleric who wrote two pamphlets about the water of provincial spa located in Peterhead, a town on the north-east coast of Scotland. I begin by outlining his education and I then reconstruct the medical theory that guided his efforts to identify tonics in the well’s water. Next, I explain why Laing and several other (...) local inhabitants thought themselves to be authorities on the palliative power of the water and I close by showing how such effects were commodified by local entrepreneurs. Although I concentrate primarily upon Peterhead Spa, this study touches upon several issues relevant to the types of medical theory and chemical experimentation that were being used in provincial Scotland during the late eighteenth and early nineteenth centuries. (shrink)

Citizens today are increasingly expected to be knowledgeable about and prepared to engage with biomedical knowledge. In this article, I wish to reframe this ‘public understanding of science’ project, and place fresh emphasis on public understandings of research: an engagement with the everyday laboratory practices of biomedicine and its associated ethics, rather than with specific scientific facts. This is not based on an assumption that non-scientists are ‘ignorant’ and are thus unable to ‘appropriately’ use or debate science; rather, it is (...) underpinned by an empirically-grounded observation that some individuals may be unfamiliar with certain specificities of particular modes of research and ethical frameworks, and, as a consequence, have their autonomy compromised when invited to participate in biomedical investigations. Drawing on the perspectives of participants in my own sociological research on the social and ethical dimensions of neuroscience, I argue that public understanding of biomedical research and its ethics should be developed both at the community level and within the research moment itself in order to enhance autonomy and promote more socially robust science. Public bioethics will have to play a key role in such an endeavour, and indeed will contribute in important ways to the opening up of new spaces of symmetrical engagement between bioethicists, scientists and wider publics—and hence to the democratisation of the bioethical enterprise. (shrink)

The imbalance between supply of organs for transplantation and demand for them is widening. Although the current international drive to re-establish procurement via non-heart beating organ donation/donor is founded therefore on necessity, the process may constitute a desirable outcome for patient and family when progression to brain stem death does not occur and conventional organ retrieval from the beating heart donor is thereby prevented. The literature accounts of this practice, however, raise concerns that risk jeopardising professional and public confidence in (...) the broader transplant programme. This article focuses on these clinical, ethical, and legal issues in the context of other approaches aimed at increasing donor numbers. The feasibility of introducing such an initiative will hinge on the ability to reassure patients, families, attendant staff, professional bodies, the wider public, law enforcement agencies, and the media that practitioners are working within explicit guidelines which are both ethically and legally defensible. (shrink)

To avoid misinterpretations one should substitute the ambiguous notion of 'new disease' with 'emerging disease'. A disease can be classified emergent in at least five dif férent historical situations; 1) it existed before it could be first identified but was overlooked from a médical point of view because it could not be conceptualized as a nosological entity; 2) it existed but was not noticed until a quantitative and/or qualitative change in its mani festations; 3) it did not exist in a (...) particular région of the world before its introduction from other régions; 4) it never existed in a human population but only in an animal population; 5) it is completely new - the triggering germ and/or necessary environmental conditions did not exist prior to the first clinical manifestations. A sériés of historical examples illustrate this classification. (shrink)

This article identifies two trends in Dooyeweerd’s conception of ‘cosmic time’, and elaborates their consequences for the philosophy of history. The first trend, connecting time to modal diversity and the order of the modal aspects, prevails in Dooyeweerd’s analysis. The application of the second trend, emphasizing that in each relation frame the temporal order governs subject-subject relations and subjectobject relations, sheds a new light on the interpretation of history conceived of as development of the culture and civilization of mankind. The (...) distinction of faith and religion and the position of the aspect of faith in the order of the modal aspects play important parts in this discussion, in particular with respect to the possibility of transcending time. (shrink)

At the law side of the creation, the Philosophy of the Cosmonomic Idea distinguishes between natural laws, values and norms. Natural laws are coercive both for human beings and for any other subject or object. Like natural laws, values or normative principles belong to the creation, being universal and invariable. Both people and associations are subject to values, which they can obey or disobey. Values characterize the relation frames following the natural ones. Norms are man-made realizations of values, historically and (...) culturally different. Philosophical ethics investigates the normativity of human acts. This paper argues that ethics cannot be related to a single relation frame and that the designation ‘ethical’ or ‘moral’ modal aspect is a misnomer. (shrink)

Discusses the metaphysics of the iterative conception of set.